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Reducible (uncomplicated)
Reducible (uncomplicated)
ASX, vague abd/inguinal discomfort
Cough impulse (expands with cough)
Irreducible (complicated)
Irreducible (complicated)
Incarcerated hernia
± Bowel obstruction
Cough impulse
Strangulated (emergency)
Bowel obstruction
No cough impulse
Overlying skin tender, erythematous
DX: Clinical, US, CT
TX: Surgical repair
Complicated: open > laparoscopic
Hernioplasty (mesh)
Herniorrhaphy (autologous tissue)
Inguinal Hernia
Inguinal Hernia
Direct inguinal hernia
Direct inguinal hernia
Directly though weak spot in Hesselbach's triangle
Inferior epigastric vessels, rectus abdominis, inguinal ligament
Indirect inguinal hernia
Indirect inguinal hernia
Incomplete obliteration (patent) of processus vaginalis
Through the internal (deep inguinal ring), "in" the spermatic cord
Invaginate scrotal skin and palpate external inguinal ring
Valsalva maneuver or cough ➔ expansion
Palpable bulge (felt laterally is indirect)
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